Provider Demographics
NPI:1558670166
Name:MILMO, BRANDI NICOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:NICOLE
Last Name:MILMO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 N SAINT MARYS ST STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-3164
Mailing Address - Country:US
Mailing Address - Phone:210-236-5108
Mailing Address - Fax:
Practice Address - Street 1:3510 N SAINT MARYS ST STE 210
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-3164
Practice Address - Country:US
Practice Address - Phone:210-236-5108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN80442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry